Sanitary hygienic evaluation covered environment quality of populated area influenced by aluminium and paper pulp enterprises. Findings are that pollution of air, drinkable water and soil with benzpyrene, suspended particles, fluorine compounds, formaldehyde, phenol and aromatic hydrocarbons exceeds current hygienic norms up to 12-fold MACs. The environmental objects constantly contain manganese, aluminium, nickel, chromium. Chronic complex intake of priority chemical pollutants forms unacceptable risk for population to get respiratory, cardiovascular and nervous system diseases, locomotory disorders, gastro-intestinal, blood and hemopoietic diseases (THI = 1.37-15.75). Level of risk-associated morbidity among the population is 1.5-2.6 times higher than on sanitary and hygienic favorable territories, and caused by higher concentration of chemical pollutants in biologic media. Chronic presence of aluminium, manganese, nickel, phenol, formaldehyde and aromatic hydrocarbons in biologic media of the population was proved to decrease functional activity of adaptational mechanisms of cardiovascular, vegetative and nervous systems and detoxication organs.

Sanitary hygienic analysis of environment and risk evaluation were performed in area under influence of major industrial agglomeration with enterprises releasing lead, manganese, nickel, cadmium and chromium. Findings are that ambient air pollution on the populated area with the studied metals does not exceed the hygienic norms. With that, chronic noncarcinogenic risk for nervous (HI 4,9) and endocrine (HI 1,1) sysems was unacceptable. Total of 183 children residing under chronic low-level airborne exposure to metals appeared to have average serum levels of manganese, nickel and chromium 1,5-9,4 times exceeding the reference levels, and 1,3-2,2 times over the reference group values (p<0,05). The children with higher serum levels of lead, manganese, nickel, cadmium and chromium appeared to have 1,7-1,8 times higher occurrence of endocrine (18,3%) and nervous (16,9%) diseases, physical development disorders - 1,2-1,6 times more frequently, vs. in the reference group (p<0,05). Relative risk of weight-height disorders (E44-E46, E34.3) was 3,05-3,5 times more thatn in the reference group (OR = 0,05; DI = 1,05-9,5; p = 0,05; OR = 3,75; DI = 1,07-17,4; p = 0,05). The study establishedprobable, statistically significant cause-effect relationship between increased serum level of lead, chromium with physical development disorders (E44-46), between serum levels of nickel, cadmium and probable development of dwarfishness (E34.3) (p<0,001).

The authors evaluated ambient air pollution (according to criteria of ecologic influence and airborne health risk to residents near the influenced zone) before and after reconstruction of major industrial enterprise. Findings are that technical renovation of the production resulted in increased influence on the ambient air. Weight of the released chemicals increased by 3,33 thousand tons/year due to more weight of common admixtures: nitrogen oxides, sulphur dioxide, carbon oxide, etc. Despite higher overall releases, the reconstruction caused less specific releases of the chemical pollutants per 1 tonn of treated oil (2,1 times). Overall individual carcinogenic risk on the sanitary protection zone border remained at MAC: 7,88'10^-6 before reconstruction, and 2,00'10^-S after reconstruction. Jeopardy indexes of acute noncarcinogenic risk of central nervous system development appeared to decrease from 0,22 Hiac (before reconstruction) to 0,09 Hiac (after reconstruction), of respiratory diseases - from 1,01 to 0,99 Hiac, of immune system diseases - from 1,02 to 0,82 Hiac, of reproductive system diseases - from 1,02 to 0,82 Hiac (respectively). Increase, but remaining of acceptable level, was shown by jeopardy indexes of system effects development (from 0,12 to 0,19 Hiac) and eye diseases (from 0,35 to 0,80 Hiac) under acute exposure to the enterprise releases. Jeopardy indexes of chronic noncarcinogenic risk of diseases concerning all organs and systems affected by the releases increased after reconstruction, but remaining on acceptable level (Hicr£1).

Examination of workers engaged into phthalic anhydride production revealed reliable changes of immune regulation parameters (if compared to normal and reference group values): decreased phagocytic activity according to "relative phagocytosis" criterion, deficit of serum IgG, hyperproduction of specific IgE antibodies to phthalic anhydride (by its metabolite - phthalic acid). Findings are reliable (if compared to the reference group) decrease of CD95 T-cell receptors expression, disordered launch and regulation of apoptosis via changed expression of TNFRI (hyperproduction) (p<0,05). Findings also included increase intracellular regulatory proteins bcl-2 and Bax production, deficiency of transcription factor p53, reliably changed in comparison with the reference group (p<0,05). The results obtained demonstrate key features of immune regulation in workers engaged into phthalic anhydride production - activated processes of natural cellular death of immunocytes and specific sensibilization to phthalic anhydride.

Opicality of the study is based on importance of genetic markers isolation to use them as indicators of arterial hypertension development in accordance with age of titanium manganese production workers. Analysis of single-nucleotide polymorphisms frequency in sites of 20 candidate genes was done with real-time polymerase chain reaction, with results assessment by allel discrimination method. Findings are that age over 40 is a modifier that has statistically significant (p<0,05) influence on disease development in the sample without genetic background consideration (OR = 3,781). Allel variants of 1^st and 2^nd phases of detoxification, nervous regulation and carbohydrate metabolism were specified - ANKK (rs1800497), SULT1A1 (rs9282861), NR3C1 (rs6195) and CYP1A1 (rs1048943) - most frequent in arterial hypertension. The cause-effect relationship between arterial hypertension and age over 40 is reliably significant in heterozygotes in ANKK (OR = 10,357) and SULT1A1 (OR = 6,462) genes, and in homozygotes of wild type in NR3C1 (OR = 4,444) and CYP1A1 (OR = 5,556). Variant allels of candidate genes ANKK (rs1800497), SULT1A1 (rs9282861), NR3C1 (rs6195), CYP1A1 (rs1048943) characterize features of arterial hypertension development, if associated with age of magnesium production workers, and are recommended as markers for decisions on lower exposure to hazardous work conditions.

The authors presented methodic approaches to evaluating share of managing entities into individual and population risks formation under exposure to chemical pollutants of ambient air, and practical application of those approaches. The evaluation is based on calculation of dust and gas releases dispersion, using composite database on pollution sources. The calculation results are matched with vector map of territory with attached populated area, helps to identify «responsibility zones» for certain managing entities, where their share into health risks exceeds 50%. The results obtained help to optimize occupational control programs for mutual implementation by several enterprises and assessment of shares made by certain legal entities into financing of environmental protection and sanitary hygienic measures.

Workers engaged into phthalic anhydride production appeared to be exposed to combined influence of several classes of chemicals (phthalic anhydride, phthalic and maleic acids, orthoxylene) and suspended substances (TSP, PM_2,5 and PM₁₀). The chemicals contents of air in the workplace did not exceed hygienic norms. Suspended substances contents appeared to exceed the norms, if compared to reference workplaces - 12,4 to 16.5 times for TSP, 1.3 to 14.0 times for PM_2,5, 1,5 to 14,4 times for PM₁₀. The workplaces «phthalic anhydride packaging», «crystallization department», «end product storage, palletizator» appeared to have 2,1 to 10,0 times exceeded calculated concentrations of nanoparticles. Jeopardy caused by influence of low-dispersion particles at chemical production is aggravated by influence and inhalation of toxic compounds adsorbed on these particles. The studies necessitate organization of occupational control over contents of TSP, PM₂₅ and PM₁₀ in air of workplace, so these concentrations can be used as additional information for assessment of work conditions, hazards and occupational risks in phthalic anhydride production.

Workers engaged into phthalic anhydride and fumaric acid production are exposed to combined occupational hazards: phthalic anhydride, maleic anhydrid, o-xylene, occupational noise, general and local vibration, heating microclimate, work hardiness. The work conditions are assessed as hazardous (class 3.2). With length of service over 5 years, serum concentration of o-xylene increased 1,5 times, that of fumaric acid - 1,2 times and phthalic acid - 3 times in major occupation workers of the studied production, if compared to the reference group with length of service under 5 years. Reliable dependence was seen between blood parameters (1,3 times increased reticolucytes), excretory and concentration function of bile ducts (1,2-1,3 tiimes increased general and direct bilirubin), antioxidant and oxidant processes (1,2 times increased MDA and AOA levels), nonspecific sensibilization (1,2 times increased lymphocytes and monocytes counts) and length of service in phthalic anhydride and fumaric acid production.

The authors assessed efficiency of prevention measures on minimizing risks of occupational influence on workers engaged into subsurface mining. 2 groups of workers were formed: 62 workers involved into prophylactic programs, 87 workers not involved into prophylactic programs. Prevention programs included optimal nutrition regime, physical exertion, periodic medicaments (on indications), physical therapy. Workers with high and extremely high cardiac risks (according to SCORE scale) were recommended treatment for serum lipids decrease. Statines were taken by 22 workers in group 1, with 2 months treatment duration before examination. Analysis of prevention programs implementation demonstrated 2,5 times decrease of constant contraindications to certain occupations.

Cardiac rhythm and conductivity disorders are significant problems in occupational fitness examination for workers with hazardous work conditions. Priority factors influencing the examiners decisions are possibilities of unconsciousness and sudden cardiac death. The authors specified pronciples of decisions in occupational fitness examination for cardiac rhythm and conductivity disorders, based on systemic relevant information included into regulation documents. The article systematizes data on occupational fitness examination for cardiac rhythm and conductivity disorders, presents recommendations on their implementation with cardiovascular risk stratification.

Based on materials of 24^th wave of Russian monitoring of economic situation and public health (RLMS-HSE), the authors characterized medical activity of workers engaged into various industries (sample of 960 individuals). Findings are that all respondents are characterized by such medical activity features as self-treatment and denial of visiting doctor for prophylaxis and diagnosis. High self-estimation of health determines more negative trend in medical activity sphere. The authors presented recommendations on improving complex programs of diseases prevention among workers, with consideration of revealed features of the respondents' medical activity. The article was prepared with financial support of RF Presedent grant for governmental support of young Russian scientists - Doctors of Science (project MD-281.2017.6).

The authors studied conditions of origin, development features, clinical manifestations of exogenic fibrosing alveolitis, immune state, free radical oxidation and central hemodynamics. Findings are that exogenic fibrosing alveolitis develops mostly in individuals who overcame acute foundry fever, with prolonged exposure to fumes with high zincum oxide content. In most cases, the disease has chronic (latent) course, prone to progress and development of respiratory failure and pulmonary hypertension. In certain cases, acute exogenic fibrosing alveolitis develops with fever, intense intoxication, pulmonary hypertension, hemoptysis and massive X-ray changes in lungs parenchyma and interstitium. Exogenic fibrosing alveolitis due to exposure to zincum oxide fumes has specific features connected with nonpurulent inflammation of interstitial respiratory units, alveols, terminal and respiratory bronchioli with outcome of fibrosis, disorders of alveolary-capillary diffustion, angioarchitecture of lesser circulation, pulmonary hypertension formation, changes in right and left part of heart, central hemodynamics. Major pathogenetic mechanism of exogenic fibrosing alveolitis is activation of free radical oxidation and depletion of antioxidant defence, nonspecific B-activation and depression of T-unit of immunity.

The article covers studies of low frequency magnetic fields parameters at workplaces of personnel servicing traction motors, results of experimental data in spectral analysis of magnetic field induction, evaluation of hazardous influencecaused by this occupational factor on the workers' health.

The adequacy of noise-induced hearing loss (NIHL) assessment at 4000 Hz («Carhart's notch») is considered as applied to identify its connection with possible speech disorders. The failure of the authors isexplained by the non-linearity of the NIHL value in this frequency range and it is proposed to use frequencies from the band of «social hearing», e.g. 1000 Hz. The importance of the studies is noted and their continuationis recommended.